Patrick’s proposal would set a more formal structure for the entire state, including the creation of a new health care council made up of top public health officials to act as a central clearinghouse for the system.

The goal of the council is to help put pressure on the market.

While it won’t have the power to directly set a price for how much a hospital or doctor can charge for an operation or test, it will try to set boundaries for the market.

INSURANCE COMMISSIONER’S ROLE

To help enforce those boundaries, the bill would maintain and strengthen the authority of the state’s insurance commissioner to review health care premiums and to reject excessive premium increases.

Excessive increases would be defined in part as rates that rise faster than the rest of the economy is growing or rates that are increasing faster than health care costs in the rest of that region.

The commissioner also would be allowed to take into account the relative health of a health care provider so community hospitals with fewer financial resources aren’t punished.

The overall goal of the legislation is to set the rules for all those in the industry to play by and to keep the pressure on the market to limit costs while allowing for enough flexibility for the market to innovate.

GLOBAL PAYMENT SYSTEM

The state’s insurers have recommended a cautious approach, saying that before pushing a global payment system that mandates more coordination among a patient’s physicians, nurses, hospitals and other care providers, the state needs to even out how much hospitals and doctors can charge.

In the same health care market, costs for similar tests and procedures can vary wildly, insurers said, and the state needs to create a more level playing field.

Health care advocacy groups, however, have urged lawmakers to act quickly, saying the recession has led to a jump in the number of people struggling to pay health care premiums.